Organization Active NPI

K Andrew Yaryan OD LLC

  • Optometrist
  • Connersville, IN
National Provider Identifier
1053638403
Registry record updated Sep 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003524A Issued in IN
Legal business name
K ANDREW YARYAN OD LLC
Practice address
522 N Eastern Ave
Connersville, IN 47331-1935
Phone
(765) 825-4127
Fax
(765) 827-6577
NPI assigned
Apr 26, 2010
Last updated
Sep 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kevin Andrew Yaryan, O.D.NPI 1508027269
Title
Owner/Optometrist
Phone
(765) 825-4127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 18003524A IN Primary

Addresses

Primary practice location

522 N Eastern Ave
Connersville, IN 47331-1935

Mailing address

522 N Eastern Ave
PO Box 427
Connersville, IN 47331-1935
Phone (765) 825-4127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100607000281 IN Part B Supplier - Clinic/Group Practice 3476683160 Receives reassigned benefits from 7 practitioners
Practice locations: Brookville, IN; Connersville, IN; Rushville, IN
O20100930080270 IN DME Supplier - Physician - Optometrist 3476683160 Practice locations: Connersville, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Yaryan Eyecare Center522 N Eastern Ave, Connersville, IN 47331-1935(765) 825-4127 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jul 1, 2010

National Provider Directory

National Provider Directory

Locations

305 Main St
Brookville, IN 47012
Phone (765) 252-0643

522 N Eastern Ave
Connersville, IN 47331
Phone (765) 233-4621

114 W 3rd St
Rushville, IN 46173
Phone (765) 204-5858

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346630400000",
    "number": "1053638403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 N EASTERN AVE",
            "address_2": "PO BOX 427",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311935",
            "telephone_number": "765-825-4127",
            "fax_number": "765-827-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 N EASTERN AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311935",
            "telephone_number": "765-825-4127",
            "fax_number": "765-827-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K ANDREW YARYAN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2012-09-03",
        "status": "A",
        "authorized_official_last_name": "YARYAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "765-825-4127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003524A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connersville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.